Scope beyond skin infections

The future: Data from animal research shows tedizolid is effective in lung infections, which will be the next step for Trius Therapeutics, said Dr. Victor Nizet, who sits on its scientific advisory board. Nizet, a professor of pharmacy and pediatrics at UC San Diego, researches bacterial infections in the immune system.

Wide scope: “It will be an important component of treatment for all forms of MRSA and gram-positive infections,” Nizet said, listing pneumonia, sinusitis, ear infections and gastrointestinal infections as examples.

The opportunity: With drug-resistant bacteria on the rise and big pharmaceutical companies restructuring their approach to R&D, there is an opening for small and midsized biotech firms to capture the market, Nizet said.

A 12-year-old boy who was diving for a basketball in his school gym in New York City got a cut on his arm. The incident was nothing out of the ordinary, but bacteria entered Rory Staunton’s bloodstream through the cut; he developed sepsis and died three days later.

The New York Times carried the story of how rapidly the infection progressed and remained undiagnosed until it was too late.

Sepsis can be caused by pathogens, such as methicillin-resistant Staphylococcus aureus, or MRSA, a staph infection that has become immune to many common antibiotics.

Although most MRSA infections are not serious, tougher strains that resist multiple drugs can be life-threatening, requiring strong new antibiotics, of which there are few on the market.

San Diego’s Trius Therapeutics is one of a handful of companies focused on developing innovative antibiotics for life-threatening diseases, including serious MRSA infections.

“With bacteria, it’s either we get smarter or they get smarter. The challenge for bacteria is to outsmart the antibiotic, which is why we need to come out with drugs that combat their clever ways,” said Dr. Michelle Abbo, a hospitalist and internal medicine specialist with Scripps Memorial Hospital.

Last December, Trius completed the first stage-three clinical trial for the oral version of tedizolid phosphate, an antibiotic that can treat acute bacterial infections of the skin and skin structure.

It’s now doing a stage-three trial for an option in which physicians can administer the drug intravenously first, then switch the patient to the oral version.

Once-a-day treatment

For reasons that are unclear, one of out of five healthy people carry the staph bacteria in their noses or in their bodies. In some people, it never shows symptoms, but it in others, it can pop up suddenly, when they get a cut or their immune system is compromised.

MRSA, a strain of staph bacteria, is carried by about 1 percent of the population. Discovered in 1961, it now resists penicillin, methicillin, amoxicillin and other antibiotics that used to kill it.

MRSA typically appears as a skin infection, spread by sharing a towel or razor, and in child-care centers and sports activities.

If acquired in a hospital, it tends to be more severe, emerging as pneumonia, or as an infection in the blood stream or a surgical site. The bacteria lives on the surface of the skin and can enter through intravenous lines and catheters.